KENNEBUNK, Maine, Dec. 28, 2015 /PRNewswire/ -- In the latest Healthcare Business Strategy report, Mark Farrah Associates (MFA), www.markfarrah.com, summarizes key findings found within the Health and Human Services (HHS) 2014 Medical Loss Ratio (MLR) report. The brief focuses on health plan performance as it relates to the Medical Loss Ratio, and the related rebates due to consumers.
The MLR provision was established by the Affordable Care Act (ACA) requiring health insurers who fail to spend specified percentages of their health care premium income to pay their customers rebates. In 2013, health plans reimbursed customers $335 million, equating to approximately $80 per family receiving a refund. In 2014, health plans reimbursed customers $478 million equating to approximately $129 per benefiting family.
MLR premiums and rebate figures were aggregated for all health plans that reported doing business in each state. For 2014, California led the country with $98 million in MLR rebates, followed by Florida's $60 million. In addition, MFA assessed the Individual, Small Group and Large Group Comprehensive market segment's Adjusted Premiums, MLR Rebates and Weighted Average MLR for leading health companies. 2014 MLR Rebates paid for the Individual segment were $238 million which is .5% of the $51.5 billion collected in premiums. MLR Rebates for the Small Group segment were $142 million, or .2% of the $70.2 billion and rebates for the $203 billion Large Group segment were $90.5 million. Overall, the rebates paid to consumers were a relatively small portion of industry premiums.
Subscribers to Mark Farrah Associates' Health Coverage Portal and the SHCE and MLR Data have access to this dataset with the benefit of NAIC company codes mapped to HIOS codes used for government reporting by health plans. MFA will continue to analyze and report on important ACA related topics with valuable insights about the health care industry in future Healthcare Business Strategy reports.
To read the full text of "A Brief Analysis of the 2014 Medical Loss Ratio & Rebates Results ", visit the Analysis Briefs library on Mark Farrah Associates' website.
About Mark Farrah Associates (MFA)
MFA is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Committed to simplifying analysis of health insurance business, our products include Medicare Business Online™, Medicare Benefits Analyzer™, Health Coverage Portal™, County Health Coverage™, Health Insurer Insights™, and Health Plans USA™.
Mark Farrah Associates
Ann Marie Wolfe, 412-944-2417
SOURCE Mark Farrah Associates